Written and medically reviewed by Dr. Mary Alice Mina, MD, FAAD, a board-certified dermatologist and Mohs surgeon. Reviewed September 2026.
About a year and a half ago, I kept catching my reflection and thinking my forehead looked taller. My part seemed wider, and I could see more scalp at my crown. I have always had thick hair, so when I mentioned it, people brushed it off. It made me think, was I going crazy? Hair thinning in midlife is one of the most common things I hear from patients. In this week’s episode of The Skin Real, I walked through my full haircare routine, and here is the grounded version you can use.
Yes, thick hair can still be thinning
You can lose real density before anyone else notices, especially if you started with a lot of hair. A smaller ponytail or more visible scalp is worth attention, and you do not have to wait until it feels severe to get help.
How I wash, and my two-shampoo method
I wash every four to seven days, and more often in summer or after hot yoga. Most people do not need to shampoo daily unless their hair is very fine. When I do wash, I treat it as a scalp day, because the scalp is the soil your follicles grow in. I shampoo twice, so the first pass lifts oil, dry shampoo, and buildup off the scalp, and the second actually cleans the strands. Conditioner goes on the mid-lengths and ends only, away from the scalp, and I let it sit a minute before rinsing. You can find the gentle, dermatologist-designed shampoo and conditioner I like in my haircare shop.
Drying and styling without the breakage
On wet hair I use a detangler and a wide-tooth comb to limit breakage, and a leave-in bond treatment helps after a summer of sun and salt. Heat protectant goes on before any hot tool. The everyday tools I reach for, including the detangler, comb, heat protectant, and claw clips, are in my Amazon storefront. I recently started using a Dyson Airwrap and I like how quickly it dries and smooths my natural wave. During the day I twist my hair up in a loose claw clip, which keeps tension off my hairline and avoids the dent a tight elastic leaves. I also try not to sleep on a wet head, since a damp scalp overnight can encourage yeast and flaking, sometimes seen as seborrheic dermatitis.
The treatments that helped me
I started with topical minoxidil, the ingredient in Rogaine, but the sticky residue meant I did not stay consistent. I switched to oral low-dose minoxidil, half a tablet a day, and both my consistency and my results improved. It can be a cost effective option for hair thinning. Just a heads-up, you may shed a little more in the first few weeks, and that is the medication clearing hairs already on their way out, not new damage. I also use a lightweight exosome scalp serum. This is my hair care splurge. Since oral minoxidil is a prescription, talk it through with your dermatologist to see if it’s a good fit for you. There are other prescriptions for hair loss that can also be beneficial.
Feed your hair from the inside
Hair is mostly protein, so I make sure I am eating enough of it, along with healthy fats, fiber, and antioxidants. I stopped recommending biotin for most people unless there is a true deficiency, which is uncommon. A large calorie deficit, including from a GLP-1 medication that curbs your appetite, can trigger shedding, so protein matters even more then. Supplements like Nutrafol, Viviscal, or Inner Glow can have a place, and I would sort out nutrition first.
Color, cuts, and going gray
I color my own hair and haven’t noticed a problem with breakage but if you are bleaching heavily or using high heat treatments, it can damage your hair. Ask your stylist about gentler options if your hair is snapping and breaking. A good stylist is a real resource for a length and shape that flatters finer hair as well. The cut really makes a world of difference. And if you decide to grow out your gray or silver, I think that is a beautiful, confident choice. Let your hair be an expression of you at every stage.
Frequently asked questions
Can I be losing hair if my hair still feels thick? Yes. People with dense hair can lose real volume before it becomes obvious, and a widening part is often the first clue.
Does washing my hair make it fall out? No. Washing removes hairs that were already shed, so you see them in the drain, but the cleansing itself does not cause loss.
Is oral minoxidil better than topical Rogaine? Neither is universally better. Oral low-dose minoxidil worked for me because I stayed consistent with a daily pill. It is prescription only, so talk with your dermatologist.
Do I still need biotin supplements? Usually not. Unless you have a diagnosed deficiency, most people do better focusing on protein and nutrition.
Get the full routine
For the complete walk-through, including the exact products and how I use them, watch the full episode on The Skin Real YouTube channel. And if you are noticing changes in your hairline or density, you do not have to sort it out alone. Get science-backed guidance inside The Skin Real app, or book a visit with me at The Skin Real Serenbe.
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